Abstract

In China, more than 80% of the esophageal cancer occurs in farmer village, and most of the esophageal cancer patients die at village home. Therefore, the cause of death for esophageal cancer patients has not been well characterized. The present study was thus undertaken to determine the causes of death in patients with esophageal squamous cell carcinoma (ESCC) to provide more information for further prevention and accurate treatment after ESCC diagnosed. All the 8,838 ESCC patients with a detailed cause of death in this study were derived from the ESCC database (1973-2015) in Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, China. All the patients were categorized by age (<50 years and≥50 years), gender (male and female) and pathological stage (early, middle and later stage). Chi-Square test was used to analyze the differences in different groups. The results demonstrated that, of the 8,838 died ESCC patients, there were 5,713 males (64.6%) with a mean age of 60.95±9.43 and 3,125 females (35.4%) with a mean age of 61.95±9.47. Notably, 69.5% of the patients died within five years after diagnosis, and the 1-, 3- and 5-year death after diagnosis for these died ESCC patients were 1622 (18.4%), 2960 (33.5%) and 1557 (17.6%), respectively. Overall, the major cause of death for ESCC was due to ESCC recurrence and metastasis (8500, 96.1%), and followed by cardiovascular disease (121, 1.4%), different infections (68, 0.8%), second cancer (52, 0.6%), accident (25, 0.3%), suicide (22, 0.2%), and uncertain cause (50, 0.6%). Furthermore, the major cause of death in males and females was similar (p>0.05) and the cause of death by ESCC recurrence and metastasis, cardiovascular disease, different infections, second cancer, accident, suicide and uncertain cause was 96% (5485) 1.5% (84), 0.8% (44), 0.6% (34), 0.3% (18), 0.2% (16), 0.6% (32), respectively in males and 96.5% (3015), 1.1% (37), 0.8% (24) 0.6% (18), 0.2% (7), 0.2% (6) and 0.6% (18), respectively in females. The present results demonstrate that recurrence and metastasis are the major cause of death both in male and female for ESCC (96%). It is noteworthy that there are 0.2 percent of the ESCC patients have suicide which call for more attention of psychotherapy on cancer patients. [Supported by the Science and Technology Major Projects of Henan Province of China (161100311300), and Correspondence to: Li Dong Wang, the National Key Research and Development Program of China and Correspondence to: Li Dong Wang. Email: ldwang2007@126.com]